Provider Demographics
NPI:1154608305
Name:COLLINGE, JOANNE (MD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:COLLINGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APARTADO 356
Mailing Address - Street 2:
Mailing Address - City:ZIHUATANEJO
Mailing Address - State:GRO
Mailing Address - Zip Code:40880
Mailing Address - Country:MX
Mailing Address - Phone:527555-554-6477
Mailing Address - Fax:
Practice Address - Street 1:APARTADO 356
Practice Address - Street 2:
Practice Address - City:ZIHUATANEJO
Practice Address - State:GRO
Practice Address - Zip Code:40880
Practice Address - Country:MX
Practice Address - Phone:755-554-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1611872080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine